The present invention relates to surgical instruments for treating female urinary stress incontinence, female cystocele, and female rectocele generally and in particular, implanting a mesh sling using fascia tissue anchors to secure the sling in position.
Urethral sling procedures have become widely used as the primary surgical procedure for treatment of stress incontinence in women. The complexity of surgical placement and technical difficulty with the anatomical positioning of the sling continues to be a problem for surgeons and patients.
Current minimally invasive sling procedures utilize a long sling material and instruments for placement of the sling that are passed through the lower abdomen or the obturator fossa of women. Residual mesh material extends to the skin of the lower abdomen when an abdominal approach is used and it extends to the skin near the labia in the trans obturator approach. The excess sling material that extends through the abdominal wall or the obturator fossa is a permanent material which remains a source for possible infection and discomfort for the remainder of the life of the patient.
A sling for treatment of urinary incontinence in women is needed that is less invasive with less risk for complications than is currently available. This is especially important for the high risk elderly woman who needs surgical management of urinary incontinence or vaginal vault prolapse. Improved surgical techniques are needed for placement of support materials for cystocele repair and rectocele repair. Current surgical techniques for placement of supporting materials in repair of cystocele and rectocele are technically difficult to secure in the correct anatomical position and do not have predictable results. A wide range of supporting materials are used by different surgeons. The different materials are usually cut to fit the perceived defect at the time of surgery and sutured in position. Classic suturing of support materials in position for cystocele repair and rectocele repair is technically difficult for the surgeon to accomplish because of compromised surgical exposure of the vaginal apex that occurs during surgery for prolapse in most patients. A surgical technique is needed that can allow the surgeon to accurately position supporting materials in the anterior vaginal wall for cystocele repair and in the posterior vaginal wall for rectocele repair.